Current pediatrics (Voprosy sovremennoi pediatrii)

Journal Information
ISSN / EISSN : 1682-5527 / 1682-5535
Current Publisher: Paediatrician Publishers LLC (10.15690)
Total articles ≅ 832
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DOAJ
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Latest articles in this journal

Leyla S. Namazova-Baranova, Kamilla E. Efendieva, Yliya G. Levina, Elena A. Vishneva, Anna A. Alekseeva, Vera G. Kalugina, Konstantin S. Volkov, Polina S. Arimova, Alina R. Pankova, Anastasiya D. Lamasova
Published: 19 September 2020
Current pediatrics, Volume 19, pp 316-324; doi:10.15690/vsp.v19i4.2136

Abstract:
The prevalence of allergies to domestic animals increases due to the increase in the number of pets worldwide, followed by serious medical and social problems. Domestic cat (Felis domesticus) is one of the most common pets and one of the most frequent (after dust mite) source of indoor allergens and risk factor for bronchial asthma and allergic rhinitis. This review collects relevant information on the issues of hypersensitivity to cat allergens (the term «cat allergy» will be used later). The authors consider issues of diagnosis, treatment and prevention of this condition. Special attention is given to the management of patients with cat allergies and particularly usage of special nutrition for cats that can reduce the level of the main cat allergen Fel d 1 in the environment. Whereas, this leads to decrease of allergic diseases symptoms severity.
Aleksandr V. Pashkov, Leyla S. Namazova-Baranova, Elena A. Vishneva, Irina V. Naumova, Irina V. Zelenkova
Published: 19 September 2020
Current pediatrics, Volume 19, pp 272-278; doi:10.15690/vsp.v19i4.2134

Abstract:
There are about 466 million people (6.1% of global population) with hearing impairment registered in the world according to the data from WHO experts. Their number exceeds 13 million in Russian Federation, and more than 1 million are children. The results of the universal audiological screening program for newborns has shown that 1 child per 1000 newborns is born deaf, another 2–3 children grow deaf during the first years of life. The number of people with hearing impairment will reach 900 million people by 2050 according to the WHO forecasts. Prevention and early diagnosis of hearing loss and rehabilitation of children with such disorders are necessary for avoiding problems with social integration. This review presents the analysis of cognitive abilities development in children and adolescents with different types and degrees of hearing loss with regard to different approaches in their management and rehabilitation.
Vasily P. Gavrilyuk, Yana V. Evseeva, Oleg V. Cherevko, Dmitry A. Severinov
Published: 19 September 2020
Current Pediatrics, Volume 19, pp 298-303; doi:10.15690/vsp.v19i4.2138

Abstract:
Background. Arthrogryposis is severe congenital musculoskeletal disease with contractures of two or more joints of the lower and/or upper limbs and usually in combination with muscular hypo- or atrophy.Clinical Case Description. Child F. was hospitalized in the department of newborns and premature babies’ pathology on 6th day of life in critical condition. Spontaneous motor activity was severely decreased. He responds to the examination with little increase in motor activity and weak painful scream. Muscle tone is dystonic: it is diffusely reduced in the proximal parts of the upper and lower limbs, in the distal parts of the upper limbs it is significantly increased, there are flexion contractures of the fingers on both hands (mostly on the left one). Passive fingers contractures reversal is difficult. There were no feet deformities or craniofacial anomalies. Hereditary history is burdened: child’s father (1984 year of birth), great-grandfather and cousin uncle (on the paternal line) have finger deformities on both hands. Father and relatives have not been diagnosed before. The clinical diagnosis was established after consultation of geneticist and orthopedist: «Distal arthrogryposis, type 2A, autosomal dominant type of inheritance with incomplete penetrance». The molecular genetic testing was not performed due to the refusal of the child's parents. Therapeutic gymnastics, stage plaster correction of finger contractures were performed in the department during the child hospitalization (21 days). Positive dynamics was noted: finger extension amplitude has increased.Conclusion. Early conservative treatment of infants with arthrogryposis allows to correct musculoskeletal deformities. Early initiation of treatment is expected to increase the amplitude of both passive and active movements in the hand joints, whereas, it will improve the function of hand grasping and self-care capacities of patients.
Published: 19 September 2020
Current pediatrics, Volume 19, pp 256-267; doi:10.15690/vsp.v19i4.2111

Abstract:
Background. The abilitation of premature infants acquires importance due to the increased prevalence of delayed health disorders in these children. The article considers the issues of individualization of rehabilitation treatment for premature infants according to prediction of perinatal pathology outcomes, determining the individual levels of «abilitation windows» and developing personalized abilitation programs.Objective. The aim of the study was to determine individual timely sensitive ontogenesis stages («abilitation windows») for premature children with various perinatal pathology, as well as the most effective methods of rehabilitation treatment according to the maturity of the child and the type of neurosomatic deficiency.Methods. Two-stage cohort study of premature children with gestational age of 250–6–300–6 weeks was conducted. Stage 1 — retrospective analysis of «abilitation windows» in 115 premature children, development of prognostic scenarios. Stage 2 — prospective cohort study of 109 premature children, using abilitation methods in this cohort according to predicted events and estimation of abilitation efficacy. Medical interventions: familyoriented educational counseling, kinesiotherapy, physiotherapy, neuroprotectors, music therapy.Results. Information matrixes on filling ontogenetic abilitation periods have been developed, as well as age limits for «abilitation windows» have been defined on the 1st stage. Sensitive interval has been established for the use of stimulating effects in extremely immature children (postconceptional age of 34–37 weeks). The leading role of abilitation protective measures has been identified. Perinatal pathology outcomes have been analyzed in children from retrospective analysis group. Direct abilitation of premature children (from birth to 18 months) was carried out on the 2nd stage of the study according to probability forecasts. The priority of non-drug abilitation methods usage in immature children was confirmed. The need in step-by-step dynamic correction of abilitation programs was established.Conclusion. Prognostic significance of perinatal period events and individual postconceptional age in «abilitation windows» development for premature children was determined. The priority of non-drug abilitation for such patients (including family-oriented pedagogics) is established.
Aelita A. Kamalova
Published: 19 September 2020
Current pediatrics, Volume 19, pp 309-315; doi:10.15690/vsp.v19i4.2140

Abstract:
Высокая концентрация холестерина в сыворотке крови, в особенности холестерина липопротеинов низкой плотности, является фактором риска развития заболеваний сердечно-сосудистой системы. В связи с этим необходимы свое временная диагностика и лечение гиперхолестеринемии у детей. Основой лечения детей с гиперхолестеринемией служит диета. В статье проанализированы современные рекомендации по питанию детей с гиперхолестеринемией. Отмечена необходимость ограничения потребления с пищей холестерина (< 200–300 мг/сут), насыщенных и трансжиров (до 8–10%), увеличения потребления моно- (> 10%) и полиненасыщенных жирных кислот (до 7–10% общей калорийности рациона). Постулируется необходимость потребления сложных углеводов с обязательным включением растворимых пищевых волокон (пектина, инулина, слизи, камеди), содержащихся во фруктах, овощах, бобовых и цельных злаках, при сохранении нормокалорийного рациона.
Tamara P. Makarova, Khakim M. Vakhitov, Dina R. Sabirova, Dinara I. Sadykova, Liliya R. Khusnutdinova, Natalya N. Firsova, Anna A. Kucheryavaya
Published: 10 August 2020
Current pediatrics, Volume 19, pp 214-219; doi:10.15690/vsp.v19i3.2117

Abstract:
Background. Mixed connective tissue disease (Sharp syndrome) is the rare chronic autoimmune pathology combining various features of systemic lupus erythematosus, systemic scleroderma, rheumatoid arthritis, dermatomyositis and high antibody titer to nuclear ribonucleoprotein. The mixed connective tissue disease may evolve into other systemic diseases over time. Description of any cases of mixed connective tissue disease and its evolution in Russian patients has not been published previously.Clinical Case Description. The results of observations of the child with clinical and immunological signs of the mixed connective tissue disease followed by the progression of systemic scleroderma symptoms and development of Sjogren's syndrome in the short period of time are presented in the article. Improvement (such as pain attenuation, increase in volume of movements in affected joints, decrease of Raynaud syndrome manifestations duration) was observed on treatment (methotrexate 10 mg/week with subsequent addition of prednisolone 0.75 mg/kg/day).Conclusion. Timely diagnostics of clinical signs of the systemic diseases debut is crucial for correct patient routing and for achieving of disease improvement.
Natalia E. Gimaldinova, Yevgenia N. Ignatieva, Olga V. Vorobyova, Lyubov A. Lyubovtseva
Published: 10 August 2020
Current Pediatrics, Volume 19, pp 207-213; doi:10.15690/vsp.v19i3.2116

Abstract:
Обоснование. Формирование пороков развития центральной нервной системы (ЦНС) может происходить на фоне внутриутробной инфекции. Соответствующие патоморфологические изменения в структурах ЦНС требуют дополнительного изучения. Описание клинического случая. Проведено морфологическое исследование головного мозга трупа ребенка, рожденного после внутриутробного инфицирования токсоплазмой и цитомегаловирусом и погибшего в возрасте 2 лет. Установлены утолщение мягкой мозговой оболочки за счет отека и очагового склероза с мутной поверхностью, распространенный тромбоз продольных, поперечных и верхнего сагиттального венозного синусов, отсутствие мозолистого тела, основной комиссуральной спайки, зияющий третий желудочек мозга и агенезия червя мозжечка, а также смешанная окклюзионная гидроцефалия. При гистологическом исследовании белого вещества головного мозга обнаружен диффузный глиоз с глиальными кистами в перивентрикулярных зонах. В стенке кист идентифицированы псевдоцисты, заполненные токсоплазмами. Отмечены признаки продуктивного васкулита. Для подтверждения связи внутриутробной инфекции с формированием аномалии головного мозга проведено сопоставление патоморфологических изменений головного мозга и внутренних органов с анамнестическими данными ребенка (перенесенная матерью в первой половине беременности токсоплазменная и цитомегаловирусная инфекция, обнаружение аномалии головного мозга у плода при проведении второго ультразвукового скрининга на сроке 21–22 нед гестации) и результатами гистологического исследования плаценты. В плаценте обнаружены патогномоничные признаки цитомегаловирусной инфекции и токсоплазмоза: цитомегалические клетки, тромбоз сосудов, ишемические инфаркты, фибриноидный некроз базальной пластинки, гипоплазия плаценты. В строме ворсин хориона, париетальном трофобласте, амнионе, децидуальной ткани выявлены токсоплазменные цисты. Заключение. Внутриутробная вирусно-паразитарная инфекция может быть причиной формирования аномалий головного мозга у внутриутробного ребенка. Вместе с тем специфических признаков (цитомегалических клеток типа «совиный глаз») цитомегаловирусной инфекции у ребенка не обнаружено, даже при наличии характерных для этой инфекции патоморфологических изменений в плаценте. Можно предположить, что развитие аномалии головного мозга у ребенка раннего возраста было связано с токсоплазменной инфекцией.
Published: 10 August 2020
Current pediatrics, Volume 19, pp 220-227; doi:10.15690/vsp.v19i3.2118

Abstract:
The article contains the analysis of optimal patterns of supplemental feeding in infants from the point of view of the concept of the First 1000 days and the possibility of fat metabolism disorders prevention. The correlation between the early supplemental feeding (before 4 months of age) with the risk of obesity is noted mainly in socially deprived families with premature termination of breastfeeding. If supplemental feeding was sustained until 5–6 months of age as well as breastfeeding, the risk of metabolic disorder development was minimal. The time and procedure for implementation of supplemental feeding according to the formula «nutrition under the control of the child» is discussed. Specific attention was paid to the excess sugar content in nutritional support for infants as the factor associated with the development of obesity in children and adolescents.
Olga B. Tamrazova, Sergey P. Seleznev, Anait V. Tamrazova
Published: 10 August 2020
Current pediatrics, Volume 19, pp 235-243; doi:10.15690/vsp.v19i3.2120

Abstract:
General information on atopic dermatitis (AD), its history and epidemiological significance are presented. Multiple etiopathogenetic factors affecting disease manifestation are identified. The absence of specific tests, laboratory and histological studies, that can help in correct AT diagnosis, is mentioned. Most of AT diagnostic schemes clarify main (major) and additional (minor) signs of disease. Clinical manifestations of AD minor signs crucial for revealing of subacute and chronic course, as well as onset of incomplete remission of disease are described. Topical AD management regimens are presented. Pathogenetic verifications for emollients and regenerating agents use are presented.
Ekaterina I. Alexeeva, Dariya D. Vankova, Tatyana M. Dvoryakovskaya, Ksenia B. Isaeva, Rina V. Denisova, Anna V. Mamutova, Aleksandra M. Chomakhidze, Tatyana V. Radygina, Irina V. Zubkova, Natalia E. Tkachenko, et al.
Published: 10 August 2020
Current pediatrics, Volume 19, pp 190-199; doi:10.15690/vsp.v19i3.2114

Abstract:
Background. Immunological potency of 13-valent pneumococcal vaccine (PCV-13) in children with systemic juvenile idiopathic arthritis (SJIA) is still unstudied. Estimates of the genetically engineered biologic drugs (GEBD) effects on pneumococcal vaccination results also remain controversial.Objective. The aim of the study was to explore the PCV-13 efficacy in patients with SJIA and who is on treatment with monoclonal antibodies against interleukin 6 receptor (tocilizumab) and interleukin 8 receptor beta (canakinumab).Methods. The study included patients under the age of 18 with SJIA in remission or active form of disease vaccinated with PCV-13. The vaccine was administered in single dose of 0.5 ml intramuscularly in patients on treatment with GEBD or 3 weeks before GEBD administration for the first time (for patients with active disease). Vaccination was considered effective at achievement of the minimum protective level of antibodies to capsular polysaccharide of pneumococcus (anti-SPP IgG; ≥ 7 U/ml) or increase of anti-SPP IgG level ≥ 2 times in 4 weeks after vaccination. The anti-SPP IgG levels were measured with enzyme immunoassay.Results. The study included 53 patients (27 girls) in remission of SJIA and 25 (16 girls) in active disease. Median age was 13.3 and 10.8 years respectively. Tocilizumab/canakinumab was administrated in 43/10 and 18/7 patients respectively. Minimum significant anti-SPP IgG level and two-fold increase in anti-SPP IgG level were recorded in 49/53 (92%) and 32/53 (60%) patients with SJIA in remission, as well as in 22/25 (88%) and 18/25 (72%) patients in active disease respectively. PCV-13 immunological potency in patients with SJIA in remission and in active disease (in those who were initially administrated and who did not receive GEBD) did not differ.Conclusion. PCV-13 vaccination allows to achieve protective antibodies level in most of the patients with SJIA in children population regardless of the disease stage and the history of GEBD administration.
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